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New Study of HIV Hot Spots

HIV infection rates of black women in certain parts of the United States is five times higher than the overall rate of infection among black women, according to a newly published study by the HIV Prevention Trials Network (HPTN).

The study, HPTN 064, looked at HIV rates in six geographic “hot spots”; that is, regions of the U.S. known to have elevated rates of HIV and poverty. Just how elevated are those HIV rates, the study aimed to address.

The hot spots included in the study were Atlanta, GA; Raleigh-Durham, NC; Washington, D.C.; Baltimore, MD; Newark, NJ; and New York, NY.

According to a report of the study in Infection Control Today, about a quarter of new HIV infections in the U.S. occur in women. Of these women, 66% are black—a figure that stands in stark contrast to the fact that black women account for 14% of the U.S. female population.

HPTN 064 (also called “The Women’s HIV SeroIncidence Study, which somehow qualifies for the questionable acronym “ISIS”) enrolled women ages 18 to 44 without a prior positive HIV test. The stated purpose of the study was “to estimate the overall HIV-1 incidence rate in women at risk for HIV acquisition in the US and to evaluate the feasibility of enrolling and following a cohort of these women.”

Among the 2,099 women enrolled in the study, 88% of whom were black, the HIV incidence was 0.24%. (As a measure of comparison, here is a chart showing HIV/AIDS rates in sub-Saharan Africa, though note that the rates show HIV/AIDS, not non-AIDS HIV) Enrollees in HPTN 064 were asked about their mental health, sexual behavior, history of sexually transmitted infections, domestic violence, social support, financial insecurity, and health care utilization.

Thirty-two women were found to have HIV infection at the time that they enrolled in the study; they had been previously unaware of their HIV status.

The findings of HPTN 064 have not been reported in the New York Times, the Washington Post, or the LA Times, even as an online blog item.

For a more graphic view of HIV/AIDS across the United States, the HIV/AIDS Atlas shows rates by county. (You have to do a quick, free registration to use the atlas.) The view is startling. Did you know that most of eastern Massachusetts has HIV rates of .174%–.309%? This is in the upper reaches of prevalence. You can also see the ultra-concentrated pockets of elevated rates around Kansas City, MO; Jackson, MI; and Little Rock, AR, among other places. In each of these areas, HIV rates are in the .174% to .309% range, while the immediately surrounding areas have much lower rates. See the bar graph on the site for a make-no-mistake view of the racial divide at play here.

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Image (showing high rates of HIV in certain areas of New Jersey) from the HIV/AIDS Atlas